Integrated approach to stroke burden: are we doing enough?

Abstract

In The Lancet Neurology, the GBD 2019 Stroke Collaborators present data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 that show that annual numbers of stroke have increased globally since 1990, with most of the stroke burden being borne by low-income and middle-income countries. 1 GBD 2019 Stroke CollaboratorsGlobal, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021; (published online Sept 3.)https://doi.org/10.1016/S1474-4422(21)00252-0 Google Scholar The age-standardised rate of deaths and disability-adjusted life-years (DALYs) due to stroke in the World Bank low-income group of countries was almost four-times higher than that in the high-income group of countries. Despite an overall decrease in age-standardised rates between 1990 and 2019, a concerning trend is the substantial increase in age-specific stroke incidence and prevalence rates in individuals younger than 70 years. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. Full-Text PDF Open Access